Senior care facilities struggling to retain nurses and other employees are increasingly turning to staffing agencies to keep their businesses going.
Molly O’Neil, who worked at one of these senior care centers, saw a problem with how the staffing agencies operated.
So she quit to create an alternative to these agencies: Superb.
Superb is attempting to bring the Nebraska senior care world into the gig economy, allowing nurses and certified nursing assistants to customize their own schedules by picking up shifts on an app.
“10 years ago, it wasn’t cool to be a taxi driver, but now a lot of people are Uber drivers,” founder and CEO O’Neil said. “I hope that Superb can bring up, not the coolness, but it can give an opportunity for more people to come into this industry.”
O’Neil basically grew up in nursing homes, starting as a dietary aide in one when she was 15.
She spent 18 years in the geriatric care industry, working as a CNA and certified medical assistant through high school and college. After getting her degree in physical therapy, she worked in the senior care field, and eventually became a director of therapy in a nursing home.
While getting her master’s degree in geriatrics, O’Neil got an even bigger job: A program director for the 254-bed nonprofit nursing home run by the Douglas County Health Center.
Recognizing the opportunity for disruption
While working at the health center, she got an inside look into how much staffing agencies charge nursing homes to hire them. These agencies hire nurses to fill shifts in various centers and charge the nursing homes extra — sometimes as much as 250% of the rate that a nursing home would pay for a direct hire, she said.
O’Neil quickly developed an idea to prevent these agencies from taking advantage of nursing homes.
“I saw these huge, huge prices they were charging and I was like, well, there is an app for everything,” O’Neil said. “There has to be an app to find nurses.”
She had the idea for Superb back in 2020, but the scarcity of nurses during the COVID-19 pandemic temporarily paused the idea. In 2021, she got initial funding through the Nebraska Prototype Grant and a grant from First National Bank.
By August 2021, she was able to beta-test her concept in a local assisted living chain, Heritage Communities. She found the gig economy style of outreach to be a success. From there, O’Neil partnered with Hillcrest Health Services in February 2022, and has slowly been bringing on new facilities to hire nurses through Superb. Three months ago, the company opened its availability to the public, bringing on outside customers for the first time.
O’Neil said she never had an intention of leaving the world of senior care, and always assumed she would move into the role of an administrator of a nursing home. She was even working on her administrator’s license when she began her work at Superb.
“I’ve always loved senior care, and fully intended to stay in it,” O’Neil said. “So running a tech company when you have a degree in geriatrics is very different.”
With Superb, O’Neil thinks she’s able to help the senior care industry in a different way.
Right now, nurse staffing agencies hold a semi-monopoly over facilities that need nurses and CNAs on the floor, she said. Because nursing homes are highly regulated and are required to have a certain number of nurses on staff at all times, these agencies can charge a significant rate that the facilities have to pay.
“They definitely kind of hold the upper hand, and they’re aware,” O’Neil said.
Helping senior care facilities manage staffing costs
O’Neil wants Superb to do the opposite, only charging nursing homes a small service fee. She believes senior care facilities should have control over their finances..
“There’s just sometimes where the bottom dollar matters so much and if you’re blowing your budget on spending money on supplemental staff, then you don’t have money to go buy wheelchairs or bed sheets for things that your residents need,” O’Neil said.
Nursing homes can use the app as the Uber of healthcare staffing, she said, posting shifts they want and paying only for those. In some buildings, Superb staff makes up half the workforce, according to O’Neil. Other facilities use it more like a dating app, having nurses try out their building a few times to see if it’s a mutual fit before hiring them.
Advocating for healthcare workers
O’Neil started Superb to save nursing homes money, but then developed a second reason for the business: advocating for healthcare workers.
Because around 30% of healthcare workers left their job after the pandemic, O’Neil realized she needed to focus on getting more nurses into the industry. She hopes that Superb allows healthcare to be more accessible by providing customizable schedules and fully transparent pay.
“Speaking from experience being a new mom, I really wouldn’t want to leave my kid for 12 hours at a time to go work a nursing shift,” she said. “That’s the reason why people frequently leave, because of that demanding schedule.”
Nurses who want to use the app go through a background check to make sure they’re qualified. Once approved, they can go through the app and see every shift available for them.
From there, a user can access a facility’s profile, checking out the location, the rates they’re offering and hours they’re asking, along with the location’s policies, procedures and values. At that point, if someone chooses to work the shift, it’s automatically added to their schedule. They clock in through the app and are paid within 24 hours.
“They are independent contractors,” O’Neil said. “They get total freedom, so they get to pick and work as much as they want or as little as they want… I think that’s been a huge pivotal thing”
People use Superb for a variety of reasons. O’Neil said single moms are a larger demographic, as they are able to work shifts around childcare. Nursing students use the app frequently, she said, as they can’t commit to the rigorous schedules a nursing home would normally require. Others value the autonomy to work whenever and wherever they want.
“We have people that use it a little bit, we have people that use it a lot, but because of that flexibility it provides, we get to capture the entire market, not just a slice,” O’Neil said.
Superb prioritizes payment transparency as well, so nurses know exactly how much each location is offering, and how much they’ll make on any given shift. This is a contrast to nursing agencies, who are often secretive about who is making what, O’Neil said.
Expanding to underserved communities
Right now O’Neil is expanding Superb to be accessible in more locations across Nebraska. They’re in talks with facilities in North Platte, Grand Island and David City, among others, to allow healthcare employees to work in underserved communities. While collecting data from users, they found that people generally are willing to drive 45 minutes to an hour for shifts if they are interested in working in that building.
Although all of their contracts thus far are with Nebraska facilities, they are planning to break into another state later into the year, O’Neil said. Superb will remain Midwest-focused, she said.
American tech startups often target either of the coasts, leaving the Midwest forgotten, she thinks.
“Plus, I do think the ‘Midwest nice’ is a real thing,” O’Neil said. “I would prefer to be able to be in a mindset with my investors and the people working with me of not sacrificing our service.”
As the Superb CEO, O’Neil said she struggles with her decreasing one-on-one conversations with the nurses and CNAs about the app. In the company’s beginning phases she would spend time conversing with nurses over their support line. She would go to buildings and talk with residents. Superb now has 14 employees, and its CEO is focusing on the company’s bigger picture.
Despite this, she said she wants to make sure there is no one at Superb that feels removed from the customers. In the future, Superb employees will volunteer in nursing homes around once a month so she and every other member of the team can remain in touch with the senior care world.
The part of her old job O’Neil misses the most though is working with residents.
“Seniors literally will say anything that’s on their mind,” O’Neil said. “They have no filter, they are just hilarious.”
But she believes Superb gives her the ability to impact the entire industry, rather than just one building.
Residents remain essential to Superb’s core mission, O’Neil said. They have strict policies in place, so if a healthcare worker cancels a shift under a certain amount of time, they are charged a penalty. This fee goes towards replacing the worker, often increasing the shift price to fill the slot quickly. .
If a nurse doesn’t show up, O’Neil said, residents could not get the full care they needed for that day.
Improving the quality of patient care
“Yes, we’re helping buildings, and we’re helping nurses, but the end goal of the service is to provide better quality care to residents in nursing homes,” O’Neil said. “Knowing how much staffing impacts the care of residents is really important to us.”
She said Superb’s high-level mission to revolutionize the senior care space comes down to three components: technology, transparency and advocacy.
“We want to give people the tools and the ability to leverage technology in the facilities.” O’Neil said. “We want transparent pricing and no price gouging to be happening. We want to advocate for facilities, but we also want to advocate for healthcare workers. I think we have a lot to influence in changing the culture of how subliminal staffing works.”
Senior care facilities are looking toward the “Silver Tsunami,” as Baby Boomers begin to reach retirement age. The U.S. Census Bureau says older people will outnumber children by 2030, for the first time in American history.
For O’Neil, Superb is where she is staying for the long term. At 33 she said she has a lot of gas in the tank. She’s planning to grow the company as large as possible.
“This industry is ripe for innovation,” she said. “It’s not going away, it’s only going to grow. I’m excited that we get to be on the growth curve.”
